title: The pharmacokinetics of ilaprazole for gastro-esophageal reflux treatment.
abstract: BACKGROUND
  Approximately 20% of the Western population is affected by gastro-esophageal reflux disease (GERD). To date, proton pump inhibitors (PPIs) represent the mainstay of GERD medical treatment. However, despite their undoubted benefit, about 40% of GERD patients display an inadequate response to these drugs. Recently, a new PPI, ilaprazole , at oral doses of 10 mg has shown higher suppression of gastric acid secretion, more prolonged plasma half-life, and similar safety compared to 20 mg omeprazole.
  
  
  METHODS
  This review provides an update on the following points: pharmacokinetic profile and metabolism of ilaprazole in relation to its pharmacodynamic properties; comparative data on the pharmacokinetics and pharmacodynamics of ilaprazole with currently available PPIs; and implications for studies on the therapeutic efficacy of ilaprazole in GERD.
  
  
  CONCLUSIONS
  Different studies show that ilaprazole, a benzimidazole derivative, has an extended plasma half-life in comparison with all other approved PPIs. In addition, ilaprazole metabolism is not significantly influenced by CYP2C19, compared to the available PPIs. Furthermore, the pharmacological characteristics of ilaprazole confer theoretical advantages that are expected to translate into an improved acid control, particularly at night time. However, studies comparing the clinical pharmacokinetics and pharmacodynamics of ilaprazole with those of second-generation PPIs are insufficient. Moreover, further investigations assessing the efficacy of ilaprazole in the management of GERD are required. In healthy volunteers, as well as in patients with gastric or duodenal ulcers, ilaprazole has not shown clinically relevant changes in hematology and biochemistry testing, nor significant treatment-related adverse symptoms.
authors.affiliation: University of Pisa, Division of Gastroenterology, Department of Internal Medicine , Pisa , Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: de Bortoli
authors.forename: Irene
authors.initials: I
authors.lastname: Martinucci
authors.forename: Maria
authors.initials: M
authors.lastname: Giacchino
authors.forename: Corrado
authors.initials: C
authors.lastname: Blandizzi
authors.forename: Santino
authors.initials: S
authors.lastname: Marchi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
authors.forename: Edoardo
authors.initials: E
authors.lastname: Savarino
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000284:Administration, Oral; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D001189:Aryl Hydrocarbon Hydroxylases / Q000378:metabolism; D001562:Benzimidazoles / Q000008:administration & dosage / Q000493:pharmacokinetics; D065731:Cytochrome P-450 CYP2C19; D004353:Drug Evaluation, Preclinical; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000473:pathology; D006207:Half-Life; D006801:Humans; D009853:Omeprazole / Q000008:administration & dosage / Q000493:pharmacokinetics; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics; D016032:Randomized Controlled Trials as Topic
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D054328:Proton Pump Inhibitors; C119615:ilaprazole; C031000:benzimidazole; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D009853:Omeprazole